Death lurks the streets of London in 1944, and it's not just from Hitler’s incessant and destructive flying bombs as they fall into the homes of DI Ted Stratton’s neighbors and friends. Murder creeps around the sound of vehicles, running feet, and the distant clang of bells as Stratton works to clear a bomb site, pulling damaged Elsie Ingram from the rubble of her destroyed house. From the very beginning of Wilson's story, the air will stink of raw and brutal destruction.

What begins as a narrative of fatigue and mental weariness engendered by a world of constant discomfort dirt and scarcity soon becomes a tale of mistaken identity shaped around doomed, unrequited love. A body surfaces on a bomb site near Middlesex hospital clothed in a soaked suit. Stratton, working with the Dr. Byrne, Middlesex’s brusque, no-nonsense pathologist, identifies the man as Dr. Reynolds, one of the head doctors at the hospital.

Wilson’s mystery unfolds in a distinctly English voice, where clothing is darned and frayed and tube trains are crammed with “heavy-eyed, putty-faced people." Stratton is under increasing pressure from his boss, DCI  Lamb, to solve the case as quickly as possible. The challenge is that the detective must learn to trust his own judgment: was his death caused by a random German bomb, or was something more sinister at work? As he fights to shed some light on Reynolds's death, Ted's wife, Jenny, is blindsided by an expected pregnancy. Volunteering at the local Rest Center, assisted by her kindly sister, Doris, Jenny can’t face having another baby in these uncertain, chaotic times.

Amid ration books, ID cards, and the constant threat of doodlebugs, each chapter of Wilson’s novel adds another layer, a veritable puzzle of three-dimensional personalities including doctors, nurses, prostitutes, and mortuary attendant Sam Todd, who with every beat of his heart aches to become a doctor. Unfolding in shards of memory, Sam reveals his major life episode: his family‘s sudden penury that has left him without a home and a father. No longer Sam, he begins his first outing as Dr. James Dacre - but his new identity is a fragile thing and must be nurtured carefully.

When a nurse at the hospital is found strangled, another layer of intrigue emerges. Stratton, gripped by a mixture of anger, grief, and disgust, is positive that the deaths of Reynolds and the nurse are somehow connected, even though the victims did not apparently knew each other well. Then there’s the dilemma of whether to believe beautiful Fay Marchant, who beguiles them all in “slack-jawed lust.”

Hatton can’t quite believe that charming, vulnerable Fay is unscrupulous. At the same time, Dacre begins to peruse her in a deluded mix of desire and anxiety. From the gruff, no-nonsense staff at Middlesex to the blackouts that envelope London “like a cocoon,” we follow Dacre through his tangle of gruesome, confused nightmares, a man transformed and reborn into the nightmares of others.

With a tense plot that hinges on a message on a grubby sheet of paper, two stolen phials of morphine, and an out-of-control Elsie Ingram, who refuses to recognize her long-suffering husband, the pendulum of Hatton’s and Dacre’s lives become tied to Jenny’s unexpected fate, Wilson’s intricate thriller speeding forwards to its exciting and shocking finale.